Inspired by the Gold In September movement born in the United States in 2012, France now dedicates the month of September to raising awareness of pediatric cancers. Serious illnesses which affect 2,500 to 3,000 young people each year in France, sometimes infants: 1 in 440 children under the age of 15 see this nasty disease intrude into their young life. Fortunately, the majority manage to overcome the disease – 80% of children recover – but at the cost of heavy treatments, not without side effects in the short, medium and long term. If those associated with chemotherapy are well known and documented, the consequences of radiotherapy are less so.
“It is a major weapon, which participates in the treatment of two thirds of cancers, and in particular brain, thoracic, back and sacrum tumors, informs Dr Pierre-Yves Bondiau, head of the radiotherapy department at the Antoine-Lacassagne Center in Nice. But, in children in particular, it has immediate toxicity, occurring during irradiation, and above all long-term toxicity, linked to damage to healthy tissues around the tumor.”
Among the most feared after-effects: growth disorders, neurocognitive difficulties… and especially secondary cancers. “It unfortunately happens that young patients who are cured of their first cancer, years later develop another very serious cancer linked to exposure to X-rays.” A very painful situation to face for the child, his family, but also the professionals who took care of him. They have therefore been delighted to have had a new, ultra-precise weapon available for several years, which considerably limits this risk.
Prevention of the risk of second cancer
“Since 2016, the CAL has had a high-energy proton therapy accelerator (Proteus® One). The principle is identical to that of conventional radiotherapy: irradiating cancer cells. On the other hand, these are beams of protons, and not X-rays, which are delivered, with a major advantage: the protons stop very precisely at the level of the tumor. Sensitive organs or tissues nearby, such as the optic nerve or certain parts of the brain, are protected; the risk of toxicity in the long term, in particular of radiation-induced cancers, is thus drastically reduced.”
If the CAL Mediterranean Proton Therapy Institute which houses this equipment is almost unique of its kind (only two other centers in France – in Paris and Caen – are equipped with a proton therapy accelerator), Dr Bondiau regrets that many Sick children, for whom this type of radiotherapy is technically possible, are still deprived of it. “We have an active queue of around 50 young patients; however, we have the capacity to treat at least twice that number. In the territory we cover, nearly 150 children are affected by cancer and who could benefit from this treatment. Where are these children who “escape” this care?
“Not in our region, Var, Alpes-Maritimes, quickly clarifies the radiotherapist. We have also established partnerships beyond, with Marseille, Montpellier, Toulouse, Lyon… who refer their young patients to us. But many children taken care of in other large cities such as Clermont-Ferrand, Bordeaux or even Toulouse are not referred to us, for different reasons: transport problems, accommodation problems, sometimes even opposition from families., regrets Dr Bondiau. Families probably insufficiently informed of the issues.